To evaluate whether patients with rhabdomyolysis and serum alanine aminotransferase (ALT) and/or aspartate aminotransferase (AST) higher than 1000 IU/L had higher mortality that patients with low aminotransferases. Retrospective analysis of intensive care unit patients with rhabdomyolysis [creatine kinase (CK) higher than 5000 IU/L]. Patients were classified in two groups: low aminotransferases group, when AST and ALT were equal or lower to 1000 IU/L, and elevated aminotransferases group, when AST or ALT was above 1000 IU/L. Forty-six out of 189 patients included in the analysis (24.3%) had elevated aminotransferases. The mortality of patients with rhabdomyolysis was 25.9 per cent, being higher in patients with elevated aminotransferases compared with patients with low aminotransferases (60.9% vs 14.7%; P < 0.001). Mortality stratified by quartiles of CK in patients with low aminotransferases was independent of the level of CK ( P = 0.67). Logistic regression analysis showed that the independent variables associated with mortality were Simplified Acute Physiology Score II [1.11 (1.07–1.16) for each point of increase, P < 0.001], the international normalized ratio value [4.2 (1.6–10.7) for each point of increase, P = 0.003], and the need of renal replacement therapy [5.4 (1.7–17.2), P = 0.004]. Patients with rhabdomyolysis with elevated serum aminotransferases had higher mortality than patients with low serum aminotransferase levels.

Case report A case of a 43-year-old male with severe pancreatitis complicated with neurological deterioration is presented. Methods and result Different neurosonological examinations using transcranial color coded duplex sonography (TCCS) were combined to obtain a certain diagnosis. Conclusion This case illustrates some of the applications of TCCS at bedside in ICU patients. These sonographic explorations are useful in the monitoring of ICU patients, and may avoid hazardous transfers to the radiology department for the patient.